Minimally invasive surgery (MIS) has proven benefits over “open surgery”: fewer complications, shorter hospitalization, lower rates of readmission and mortality, and lower health care costs.
Unfortunately, the population that might benefit the most from this approach is under-served. A recently published study used a Medicare database to analyze minimally invasive vs. traditional open surgeries in elderly patients. The study considered the most common surgeries for that population (bariatric, cholecystectomy, colectomy, hysterectomy, inguinal hernia, thoracic, and ventral hernia procedures). The researchers found profound differences in outcomes following surgery, with MIS having important advantages for the patient. But — counterintuitively — they also found that older individuals were provided MIS instead of open surgery at a lower rate than the general population.
Reducing post-surgical complications in older patients, especially frail individuals, is particularly important since complications are likelier to trigger a cascade of harmful outcomes in such patients. The authors dryly concluded in a press statement that “underuse of MIS for eligible candidates in the Medicare population is an example of low-value care.”
What can you do? If you or someone you know (especially an elderly patient) is scheduled for surgery, be sure to evaluate all the options and have a conversation with your physician about minimally invasive surgical options.